Cardiac/Vascular Nurse Exam Secrets Study Guide (39 page)

d. a general power of attorney.

86. A postoperative patient develops a wound infection and plans to sue the hospital. Which department would deal with the suit?

a. The administration

b. Risk management

c. Human resources

d. Infection control

87. To evaluate the expected educational outcome for a patient who has recently been taught a procedure, the nurse should:

a. ask the patient for feedback.

b. ask the patient to do a demonstration.

c. give the patient an oral test.

d. give the patient a written test.

88. A newly hired nurse is assisting the team leader, who is preparing to insert an intravenous (IV) catheter. The team leader drops the sterile catheter onto the bed linens and then picks up the contaminated catheter and prepares to continue with the insertion. The newly hired nurse should:

a. wait until the team leader finishes the procedure and ask for clarification

b. report the team leader’s behavior to a supervisor after the catheter is inserted.

c. say nothing to anyone as the linens were clean and did not contaminate the catheter.

d. state that the catheter is now contaminated and ask if she could get another setup.

89. The Centers for Disease Control’s 5-P approach to questioning is used to assess:

a. family history.

b. functional ability.

c. sexual history and risk.

d. pressure ulcer risk.

90. A patient is receiving warfarin (Coumadin) along with other treatment for atrial fibrillation. The international normalized ratio range should be:

a. 1.5–2.

b. 2–3.

c. 3–4.

d. >4.

91. One-day after open-heart surgery, a 50-year old woman from Saudi Arabia becomes very upset and refuses care when a male nurse prepares to change her dressing. The best response in this situation is to:

a. explain that he is the only nurse available to do this treatment and that the hospital does not consider gender in assignments.

b. record in the chart that the patient refused care and skip the dressing change.

c. explain that she has no right to refuse care since she signed the surgery permit.

d. reassure the patient that arrangements will be made for a female nurse to change the dressing.

92. A patient with the recent implantation of a pacemaker develops severe hiccups, which indicates:

a. irritation of the ventricular wall.

b. phrenic nerve or muscle stimulation from dislocation of leads.

c. impending cardiac tamponade.

d. allergic response to medications.

93. A patient complains of exercise-induced angina, which manifests as chest pain radiating down the left arm and lasting 5 minutes or less. This type of angina is:

a. stable.

b. unstable.

c. a coronary artery spasm.

d. a variant (Prinzmetal’s).

94. The nurse enters a patient’s room after the physician leaves and finds the patient shaking and distraught. Which of the following responses is best in this situation?

a. “What is wrong?”

b. “Do you want me to call your family?”

c. “You are shaking and seem worried.”

d. “You do not need to worry; everything will be all right.”

95. National guidelines recommend that adults participate in exercise of moderate intensity for approximately how many minutes each day?

a. 20 minutes daily to a minimum total of 100 minutes weekly

b. 30 minutes daily to a minimum of 150 minutes weekly

c. 90 minutes daily to a minimum of 300 minutes weekly

d. 10 minutes daily to a minimum of 60 minutes weekly

96. A patient is being considered for thrombolytic therapy with alteplase tissue-type plasminogen activator (t-PA). Contraindications to thrombolytic therapy include which of the following?

a. The patient has a 3.5 cm aortic aneurysm.

b. It has been 2 hours since the onset of symptoms.

c. The patient’s blood pressure has been 180/90 mm Hg but is now controlled by medication.

d. The patient had an ischemic stroke 6 months previously.

97. The CAGE tool is used to assess people for:

a. prescription drug abuse.

b. cocaine abuse.

c. gambling addiction.

d. alcohol abuse.

98. Which of the following medications should be discontinued for a minimum of 48 hours before cardioversion?

a. Digoxin

b. Warfarin

c. Cardizem

d. Insulin

99. A patient with heart failure has no symptoms at rest, but symptoms appear with physical exertion and cause some limitations of activities of daily living and slight pulmonary edema. This heart failure is classified as:

a. class I.

b. class II.

c. class III.

d. class IV.

100. Working for the best interests of the patient despite a conflict with personal values and assisting patients to have access to appropriate resources can be described as:

a. moral agency.

b. advocacy.

c. agency.

d. collaboration.

101. The treatment of choice for significant pulmonary stenosis is:

a. closed valvotomy.

b. open valvotomy.

c. balloon valvuloplasty.

d. valve replacement with homograft valve.

102. An 80-year old, severely arthritic patient recently suffered a myocardial infarction. She has limited use of her hands, is sometimes forgetful, and is currently very anxious. This patient is likely to experience which of the following barriers to learning self-care?

a. Psychological and cognitive

b. Physical and cognitive

c. Physical only

d. Psychological, physical, and cognitive

103. Which of the following medications may be used after cardiac surgery to treat low cardiac output?

a. Nitroprusside

b. Dobutamine

c. Dopamine

d. Isoproterenol

104. When preparing written materials for patients, what reading level would be appropriate for a homogeneous group of adults in an affluent area?

a. Grade 3 level

b. Grade 6 level

c. Grade 9 level

d. Grade 12 level

105. During an interview with a patient, what type of patient response elicits the most important information about the patient?

a. Verbal responses

b. Non-verbal responses

c. Silence

d. Verbal and non-verbal responses

106. A 65-year old woman who is 5 feet 4 inches tall and weighs 180 pounds has mild congestive heart failure and diabetes type 1. She states that in the last 2 weeks she ate only 800 calories/day and lost 15 pounds with 5–8 minutes of daily exercise. What advice should the nurse give to this patient?

a. The patient should increase caloric intake and exercise and maintain a weight loss at 1–2 pounds/week.

b. The patient should maintain this effective diet and exercise plan until she reaches her desired weight.

c. The patient should increase her caloric intake and try to maintain a weight loss of 5 pounds/week.

d. The patient should maintain the current 800-calorie diet plan but should increase exercise to 30 minutes/day.

107. Which of the following impediments to communication may exist when a nurse interviews a patient who is hearing impaired?

a. The nurse uses a normal tone of voice and speaks in short sentences.

b. The nurse provides assistive devices, such as writing materials.

c. The nurse is facing the patient with a distance of 5 feet between the patient and the nurse.

d. The nurse is chewing gum to freshen her breath.

108. Monitoring a patient for acute rejection after cardiac transplantation is primarily done by:

a. reviewing clinical symptoms.

b. blood testing.

c. biopsy.

d. electrocardiogram.

109. A 50-year old man who practices Catholicism is dying from cardiovascular disease. He asks to take final communion at 2 a.m. The nurse should do which of the following?

a. Contact the patient’s priest or a priest on call for the institution and ask him to come right away.

b. Tell the patient that no priest is available.

c. Ask the patient if he would be willing to see the Protestant chaplain who is on call.

d. Tell the patient the priest will be called at 7 a.m.

110. When examining the chest, where is the apex beat (pulsation) usually observed?

a. It cannot be observed, only palpated

b. Around the third intercostal space on the left mid-clavicular line

c. Around the fourth intercostal space on the left mid-clavicular line

d. Around the fifth intercostal space on the left mid-clavicular line

111. First-line drugs for the treatment of stage I hypertension are:

a. loop diuretics.

b. thiazide diuretics.

c. angiotensin-converting enzyme inhibitors.

d. calcium channel blockers.

112. Medication errors are most likely to result from:

a. hand block printing of all orders.

b. use of bar coding and scanners.

c. orders written on the computer.

d. use of medical abbreviations.

113. Which immunizations are routinely ordered for adults 60–65 years of age and older?

a. Influenza vaccine only

b. Pneumococcal polysaccharide-23, influenza vaccine, and herpes zoster vaccine

c. Hepatitis A and B vaccines

d. Influenza and hepatitis C vaccines.

114. An effective guide for performance improvement that provides evidence of how well a process succeeds is:

a. the recidivism rate.

b. a patient satisfaction survey.

c. the outcome data.

d. staff surveys.

115. Which medication order below is written correctly?

a. Maalox 30 cc PO qhs

b. Lasix 40.0 mg PO daily

c. MS 4.0 mg IV q 4 hr prn

d. Synthroid 0.88 mg PO daily at 0700.

116. The nurse attempts to start an intravenous (IV) line on an elderly patient, but the patient refuses to cooperate. The nurse tells the patient that the nursing assistant will be called to hold him down if he does not cooperate. This nurse’s response is best characterized as:

a. coercion.

b. non-therapeutic communication.

c. abuse.

d. poor judgment.

117. Sexual dysfunction after a heart transplant is primarily caused by:

a. immunosuppressive drugs.

b. anxiety.

c. weakness and malaise.

d. antihypertensive drugs.

118. A 62-year old male patient has a regular pulse of over 100 bpm with P waves occurring before the QRS complex and sometimes preceding the T wave. The QRS complex is a normal shape and duration. The PR interval is 0.12–0.20 sec, and the P:QRS ratio is 1:1. Based on these findings, the cardiac diagnosis is:

a. sinus bradycardia.

b. sinus tachycardia.

c. sinus arrhythmia.

d. premature atrial contractions.

119. When assessing educational outcomes, what kind of outcome data provide information about cost-effectiveness?

a. Clinical data

b. Physiological data

c. Integrative data

d. Psychosocial data

120. When considering outcome measures, striving for patient satisfaction is:

a. a long-term outcome.

b. a short-term outcome.

c. a long-term and a short-term outcome.